Healthcare Provider Details

I. General information

NPI: 1326353806
Provider Name (Legal Business Name): REHAB SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2010
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 N 900 E
NEPHI UT
84648-1658
US

IV. Provider business mailing address

340 N 900 E
NEPHI UT
84648-1658
US

V. Phone/Fax

Practice location:
  • Phone: 435-623-0239
  • Fax: 435-623-0239
Mailing address:
  • Phone: 435-623-0239
  • Fax: 435-623-0239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number107004-4201
License Number StateUT

VIII. Authorized Official

Name: MR. BLAIN WARREN BRADFORD
Title or Position: PRES
Credential: OTR/L
Phone: 435-623-0239